A dose of technology: the gamers taking on Ebola

More than 11,000 people died in the worst outbreak of the disease on record. In August and September 2014, around 300 to 400 new cases were reported each week in Liberia, the worst affected country, according to the World Health Organisation (WHO).

But the outbreak also unleashed a wave of creativity, as health organisations rushed to find new ways to treat patients and stymie the virus’ spread.

For the group in Seattle, one question was how to protect the caregivers. At a three-day hackathon in October – run by medical tech company Shift Labs – gamers, UX specialists and medical staff came up with a prototype video game. The game prepares volunteer doctors and nurses for the stringent protocols and unwieldy protection suits of West Africa’s Ebola Treatment Units – including the order with which to put on the suit, mask and gloves, and replicating the fogging up of protective glasses in the heat.

Here, Philanthropy Age talks to engineering professor and entrepreneur Beth Kolko, who founded Seattle-based Shift Labs in 2012. She tells us about the hackathon, how technology can improve healthcare for the poorest, and the challenges of making low-cost medical devices for the bottom of the pyramid.

Q Why did you set up Shift Labs?

I had been a professor for about 20 years and I became frustrated at some of the systemic challenges to commercialising innovations, particularly low-cost innovations in the healthcare sector.

All the work I had been doing at the University of Washington was about finding solutions for the bottom of the pyramid and building simple, robust products that could improve healthcare for people around the world. So I started a company to try and turn prototypes into products.

Healthcare is a very evidence-driven business. Getting people to accept new devices or new standards of care is extremely challenging. From the stories we heard from others in the community, we’ve been able to focus our product development efforts on building on top of existing standards of care, so our products fit into pre-existing workflows.

We’re making some headway now: we discovered some weak points in the system, which we’re pushing on using technology. For example, there’s been a tremendous amount of progress when it comes to mobile technologies and the medical device industry has not yet fully leveraged these advances to capture value.

Q How did the Ebola Training Hackathon come about?

Shift Labs’ chief medical officer is a consultant for WHO and a member of the IMAI-IMCI Alliance (the Integrated Management of Adolescent and Adult Illness Alliance, a global health network). The IMAI-IMCI Alliance was putting together a training curriculum for WHO-sponsored training in West Africa; they had a classroom curriculum and wanted to augment it with something more interactive for the many volunteers from around the world going to work in the Ebola Treatment Units (ETU).

There was no money available, so in just a few weeks we put together a Hackathon where people were willing to donate their time and effort. There were around 40 to 50 people at the Hackathon at its peak, and a core of around two dozen stayed for the full three days. They included people from Seattle’s gaming community, doctors from the global health community, the head of the University of Washington’s medical simulation centre and a doctor and a nurse who had just returned from an ETU in Sierra Leone.

Everyone was a volunteer, the only cost of the Hackathon was the food bill. At the start we announced prizes for the teams, but at the end of the event everyone voted to donate the prize money of around $1,000, which was shared equally between WHO and Médecins Sans Frontières, a global health NGO.

Q Why did you choose the Hackathon approach?

Hackathons can be amazing opportunities to leverage community-based expertise and it meant we could go fast and do it cheaply. Building games is not talent we have in-house at Shift Labs, but we see our role as helping to bring talent together to address needs.

Having the healthcare workers there who had been to Sierra Leone was priceless, too. Many of the questions the technical participants had were about struggling to define what the people on the ground needed the most. They didn’t want to build something cool for the sake of being cool; they wanted to build something useful.

One of the biggest challenges of Hackathons, however, is what do you do after the event? In our case, some of the volunteers stayed on to polish up the prototype, which remains an open source product, that we handed over to the IMAI Alliance. Although the Alliance didn’t get to use the game this time as far as I know, now the Ebola outbreak has waned they can think about how to leverage additional platforms for training volunteers going to an outbreak zone in the future.

This type of training could be used in developing markets as well. More and more people have smartphones all over the world, you can do a lot with an Android tablet and you can do a lot with basic digital platforms to augment training opportunities.

It also opens up opportunities for mentorship: if I’m using a digital platform for training, that same platform can connect me to practitioners not just in my local community, but also in the broader health community. Rather than flying in a consultant to do a one-off training who then disappears, you could instead build a network of practitioners around the world who continue to interact.

Q What is Shift Labs’ role in helping the Ebola effort?

The outcome of all of this for Shift Labs was unexpected. The White House Office of Science and Technology Policy heard about the Hackathon and got in touch. They mentioned a USAID Ebola grand challenge grant competition that was closing that day and recommended we apply for one of Shift Labs’ products, the DripAssist.

Despite only having a day to apply, we won $318,000 to test the product in an Ebola Treatment Unit in West Africa. We’re going out to the region in a few weeks to start field tests of the equipment, gathering data on how it performs as well as how useable it is once staff are wearing all the personal protective gear.

The DripAssist monitors the rate at which fluids are administered to patients. Right now the principal way IV (intravenous) drips are monitored in ETUs is counting the drops by hand. We want to provide precision measurement; the device has an alarm for when the fluid bag runs empty or the patient moves or the flow rate changes, and it runs off one AA battery.

We’re very excited about the field tests, but it wouldn’t have happened if we hadn’t volunteered to put together the Ebola Hackathon.

Q What do you hope to achieve with the Shift Labs model?

We introduced the DripAssist into the veterinarian market just under a year ago and the process is under way to have it on the medical market as well. In the US and other developed markets the cost is around $300 each, but we want to offer a substantial discount in less developed economies of around one-third the price.

We’re not a charity, we want to be self-sustaining. But we also want to build products that people love, which work in environments where they and patients are happy and satisfied with the level of care.

As a company we ran for three years before we got any funding. But early this year we spent some time in California at Y Combinator (a startup accelerator), where we raised quite a bit more seed funding than we anticipated, so we’re excited about our next steps. We’re looking at developing products in therapies related to oxygen, which are similar to IV fluids as one of the basic therapeutic approaches. We want to build products that address pressing healthcare needs and where a low-cost competitor can make a difference.